Funding Auditor

Funding Auditor – Responsibilities Partner with the Stop‑Loss team to obtain, review, and reconcile transaction detail, claim reimbursement reports, and payment files ensuring accurate reflection of stop‑loss recoveries. Coordinate and execute timely transfer of funds from reinsurance accounts to the appropriate employer or payor funding accounts in accordance with contractual requirements and internal controls. Accurately apply stop‑loss and reinsurance proceeds to applicable claims and funding accounts, verify proper allocation of claim, plan year, and funding source, and resolve discrepancies. Prepare, review, and submit stop‑loss reimbursement and funding requests to employer groups and internal stakeholders while maintaining required account thresholds. Conduct detailed account audits across multiple plan years, validating funding accuracy, claims payments, reimbursements, and transaction history, and ensuring all activity is properly documented. Audit traditional self‑funded accounts to confirm balances, funding transactions, and claims activity are accurate, complete, and compliant with plan terms, stop‑loss agreements, and internal audit standards. Leverage proprietary AI‑enabled platforms to enhance accuracy, efficiency, and insight across funding, reinsurance, and audit activities. Perform other projects, duties, and tasks as assigned. Qualifications High School diploma or equivalent required. Associate’s or Bachelor’s degree in Accounting, Finance, Business, Healthcare Administration, or related field preferred. Previous experience in health benefits administration, billing/funding, audit support, claims, or insurance operations. Prior experience with reinsurance preferred. Familiarity with claim software systems helpful. Strong attention to detail and ability to follow written procedures in a compliance‑sensitive environment. Demonstrated accuracy and consistency in data entry. Self‑motivated with the ability to manage routine tasks independently. Intermediate computer proficiency, especially with Microsoft Excel (filters, pivots), and ability to learn new systems. Benefits Competitive pay. A safe and healthy work environment provided by a robust benefit program including family health and wellness programs, 401(k), employee assistance programs, paid time off, and paid holidays. Career advancement and development opportunities. Relation Insurance Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. The wage range for this role has been disclosed but may be adjusted based on factors such as skill set, experience, and business needs. Participation in a discretionary annual incentive program may be available subject to applicable rules. #J-18808-Ljbffr Edison Health Solutions, LLC